Exercise for fitness, chronic disease and frailty

Movement is one of the most powerful treatments there is. Clinical exercise is the evidence based use of physical activity to improve health, manage symptoms and reduce future health risks. Whatever your age or health, the right activity can help you feel stronger, live better and stay independent for longer.

See how much to do Getting started safely
150–300minutes of moderate activity a week for adults
2+days a week of muscle-strengthening
3+days a week of balance & strength if you're 65+

Exercise as medicine

Why exercise matters

Regular physical activity lowers the risk of early death, heart disease, high blood pressure, type 2 diabetes and several cancers, as well as improving mood, sleep and thinking.1

If you already live with a chronic condition, the message is the same: some activity is better than none and more brings extra benefit. Exercise is an effective therapy across many chronic diseases,3 especially if it is tailored to the needs of the individual.

Although exercise is powerful, it is not a cure-all. It should not replace urgent treatment for serious illness.

The bottom line: think of activity as a prescription. It works, the dose matters and it's rarely too late to start.

WHO physical activity guidelines

How much should you do?

Recommendations for adults aged 18–64, including those with chronic conditions.2

Aerobic activity

150–300 minutes of moderate activity (like brisk walking) each week, or 75–150 minutes of vigorous activity per week. This does not have to be in one session.

Muscle strengthening

Work all the major muscle groups on 2 or more days a week, using weights, resistance bands or your own body weight.

Sit less, move more

Limit the time you spend sitting and replace it with activity of any intensity, including gentle, light movement.

Healthy ageing

Exercise and frailty: staying strong as you age

Frailty means the body has less reserve to bounce back from illness, injury or stress, often showing as weakness, slowness, tiredness and unintended weight loss. It's common in older age but it is not an inevitable part of getting older. Exercise is one of the best ways to slow or reverse it.

WHO recommendations for older adults

Adults aged 65 and over should do varied multicomponent activities. Emphasise functional balance and strength at a moderate or greater intensity on 3 or more days a week, to boost function and prevent falls.5 Being as active as your ability allows is the goal. Even small amounts help.

Can frailty be reversed?

Often, yes, especially in its earlier stages. Multicomponent exercise programmes (combining strength, balance and aerobic work) reduce frailty and improve day-to-day function.6 Progressive resistance training improves muscle strength, walking speed and physical performance.7

Preventing falls

Regular activity that includes balance and strength work reduces both the rate of falls and the risk of injury from falls.5

Practical steps

Getting started safely

1

Begin with light activity and build up slowly.

2

Choose things you enjoy, such as walking, cycling, swimming, gardening or chair-based exercises.

3

For strength and balance work, use a sturdy chair or worktop for support at first.

4

Break it up. Short sessions across the day add up.

Stop and seek advice if you experience chest pain, severe breathlessness or dizziness.

Working with your doctor

Most people can safely become more active but the programme should match the person. Sudden chest pain, fainting, severe breathlessness, new neurological symptoms or an acute injury require medical assessment.

Seek advice if you have a heart condition, poorly controlled diabetes, frailty, a history of falls, or new or unstable symptoms. People with unstable medical conditions, recent surgery or complex health needs should obtain individual advice before increasing exercise intensity.4

Common questions

Frequently asked questions

How much exercise should I do if I have a chronic condition?

Aim for 150–300 minutes of moderate activity a week, plus muscle-strengthening on 2 or more days. Some activity is always better than none. This does not have to be in one go. Small chunks add up.2

What exercise is best if I am frail or older?

Varied multicomponent activities with a focus on balance and strength, on 3 or more days a week, are recommended for adults aged 65+ to improve function and prevent falls.5

Can exercise reverse frailty?

It often can, particularly in the earlier stages. Multicomponent and resistance-based programmes reduce frailty and improve strength, walking speed and function.6

Do I need my doctor's clearance before exercising?

For most people without symptoms, routine clearance isn't required. If you have a heart condition, unstable symptoms, poorly controlled diabetes, frailty or a history of falls, speak to your doctor first.1

Ready to get moving?

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Evidence

References

  1. Bull FC, et al. WHO 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451–1462. bjsm.bmj.com
  2. WHO. Guidelines on physical activity and sedentary behaviour. 2020. iris.who.int
  3. Pedersen BK, Saltin B. Exercise as medicine: 26 chronic diseases. Scand J Med Sci Sports. 2015. onlinelibrary.wiley.com
  4. Warburton DER, et al. Prescribing exercise interventions for patients with chronic conditions. CMAJ. 2016;188(7):510–518. cmaj.ca
  5. WHO physical activity recommendations for older adults (65+). NCBI Bookshelf NBK566046. 2020. ncbi.nlm.nih.gov
  6. Multicomponent exercise programme reduces frailty and improves function in older adults. PMC7312630. pmc.ncbi.nlm.nih.gov
  7. Dose-response of resistance training on functional performance in frail and pre-frail older adults: meta-analysis. 2023. pubmed.ncbi.nlm.nih.gov